Search Results (2,146)

Background/Objectives. Social and Emotional Education (SEE) interventions during early childhood have shown considerable promise in enhancing children’s emotion understanding, social competence, and behavioural adjustments. However, few studies have examined their long-term impact, especially across the preschool-to-primary school transition. This study evaluated the effectiveness of a manualized SEE program, Timmy’s Trip to Planet Earth, in promoting emotional, behavioural, and social functioning over time. Methods. A quasi-experimental longitudinal design was adopted with pre- and post-test assessments conducted approximately 18 months apart. Participants were 89 typically developing children (aged 59–71 months), assigned to an experimental group (n = 45) or a waiting-list group (n = 44). The program combined teacher training, classroom-based lessons, home activities, and teachers’ ongoing implementation support. The effectiveness of the program was measured via the Test of Emotion Comprehension (TEC), the Strengths and Difficulties Questionnaire (SDQ), and the Social Competence and Behavior Evaluation (SCBE-30). Results. Significant Time × Group interactions were observed for the TEC External and Mental components, indicating greater improvements in emotion recognition and mental state understanding in the intervention group. The SDQ revealed significant reductions in conduct problems and increased prosocial behaviours. In the SCBE-30, a significant interaction effect was found for social competence, with the intervention group showing greater improvement over time compared to the control group. Conclusions. The findings suggest that SEE programs can produce meaningful and lasting improvements in children’s emotional and social skills across key educational transitions. Teacher training and family involvement likely played a critical role in supporting the program’s sustained impact. Full article

Since the start of the energy crisis in 2020, the Dutch government has introduced various programmes aimed at alleviating energy poverty among low-income households. This research examines the effects of three specific interventions—energy coaching, home renovations, and white goods schemes—on a range of energy poverty-related aspects, including living comfort, physical and mental health, energy costs, financial concerns, social connection, neighbourhood involvement, and sustainable behaviour. While previous studies have mostly investigated these interventions in isolation, this research offers a comparative analysis to explore how their impacts differ and how they may complement one another. This research, comparing an intervention group and control, shows that energy coaches, renovations, and white goods schemes each have positive effects on various aspects of energy poverty. However, the nature and magnitude of these effects differ by type of support measure. Renovations are the most effective overall, significantly improving living comfort, physical health, and reducing energy costs. White goods schemes primarily reduce moisture and mould in dwellings and have a notable positive impact on mental health. Energy coaches contribute to improved living comfort, lower energy costs, and uniquely enhance community involvement. The complementary nature of these interventions highlights the potential added value of integrated or combined approaches to tackling energy poverty. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Background/Objectives: Single-dose pre-operative antibiotic prophylaxis for cardiac-device implantation is recommended but extending antibiotic prophylaxis is common. Locally, 50–60% of patients had extended prophylaxis after pacemaker insertion or generator change. Our antimicrobial stewardship programme (ASP) incorporated behavioural change strategies in implementing a multi-pronged intervention bundle to address this and evaluated its effectiveness and safety. Methods: This single-centre, retrospective cohort study included patients aged 21 years old or older, undergoing uncomplicated pacemaker insertion or generator change at Singapore General Hospital (SGH) from October 2022 to March 2025. To improve antibiotic use, ASP interventions incorporating behaviour change strategies were implemented, namely (1) data-driven feedback, (2) targeted education, (3) identification and engagement of ASP champion, and (4) clinical pathway revision. Results: There were 779 patients evaluated; 380 (48.8%) received standard prophylaxis while 399 (51.2%) received extended prophylaxis with oral antibiotics (mean duration, 3.3 ± 0.8 days). Following ASP interventions, the practice of extended prophylaxis declined significantly from 43.8% to 24.0% (p < 0.01). The incidence of surgical site infections was low and similar in both groups (0.8%, p = 1.000); all infections were superficial. There was also significant reduction in the proportion of patients on all antibiotics from 20.7% to 16.3% (p < 0.01). Identification and engagement of ASP champion proved pivotal in changing prescribing behaviour through peer influence and credibility. Conclusions: The bundled ASP interventions, incorporating behavioural change strategies, have effectively and safely reduced the use of extended prophylaxis post-cardiac device implantation. Behavioural change interventions are essential to achieve sustained stewardship success. Full article

Shift work can have an adverse impact on sleep and wellbeing, as well as negative consequences for workplace safety and productivity. SleepShifters is a co-developed sleep management programme that aims to equip shift workers and employers with the skills needed to manage sleep from the onset of employment, thus preventing sleep problems and their associated consequences from arising. This paper describes the co-development process and resulting programme protocol of SleepShifters, designed in line with the Medical Research Council’s framework for the development and evaluation of complex interventions. Programme components were co-produced in partnership with stakeholders from four organisations across the United Kingdom, following an iterative, four-stage process based on focus groups and interviews. As well as a handbook containing guidance on shift scheduling, workplace lighting, and controlled rest periods, SleepShifters consists of five key components: (1) an annual sleep awareness event; (2) a digital sleep training induction module for new starters; (3) a monthly-themed sleep awareness campaign; (4) a website, hosting a digital Cognitive Behavioural Therapy for insomnia platform and supportive video case studies from shift-working peers; (5) a sleep scheduling app for employees. Future work will implement and assess the effectiveness of delivering SleepShifters in organisational settings. Full article

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. Full article

Understanding the effectiveness of suicide prevention measures for high-risk locations can often be challenging as many rely, at least to some degree, on psychological processes (e.g., engaging with help-seeking behaviours). Establishing how these measures may influence decision-making during a suicide attempt could be helpful for understanding how and when they may be most effective at preventing deaths. In the present work, we consider how suicide prevention measures may influence “goal pursuit” as it unfolds. Drawing on findings from across the suicide prevention literature, we apply the descriptive framework outlined in GOAL Architecture to consider how different measures may shape perceptions of “distance”, “time”, and “rate of progress” and, in turn, could influence levels of motivational drive associated with specific acts (e.g., “accessing means for suicide”). This is discussed in relation to real-time decisions around accessing means for suicide, avoiding intervention by a third party, and engaging in help-seeking behaviours. As well as the psychological processes that could encourage or prevent an individual from disengaging from a suicide attempt, we also consider potential risks and the influence of person-level factors. Full article

Background: Behavioural heterogeneity in obesity is increasingly recognised, but how specific dietary patterns, food preferences and physical activity vary between obesity classes remains poorly characterised. Methods: We analysed behavioural, dietary, and lifestyle data from 1366 adults attending a tertiary obesity clinic in Italy. Participants were stratified into five obesity classes defined by BMI. Age-adjusted regression models and chi-square tests with Bonferroni correction were used to examine associations between obesity severity and key behavioural outcomes, including food preferences, eating behaviours, physical activity, and self-reported sleep quality. Results: The prevalence of uncontrolled eating, skipping meals, and fast eating significantly increased with obesity severity after adjusting for age (all p < 0.05). Preference for yoghurt and legumes declined with increasing BMI, whereas preferences for meat and dairy remained stable. Age-adjusted sport participation decreased progressively, with significantly lower odds in Obesity I, II, and IIIA compared to the Overweight group. Sleep quality was highest among overweight participants and declined with obesity severity; night-time awakenings were most frequent in Obesity IIIB. Conclusions: Distinct behavioural and lifestyle traits, including lower sport participation, reduced preference for fibre-rich foods, and greater frequency of uncontrolled, fast, and irregular eating, showed overall trends across obesity classes. While these findings suggest the presence of behavioural phenotypes, their interpretation is limited by the cross-sectional design and the use of self-reported, non-validated measures. Future studies should incorporate objective assessments to inform targeted obesity interventions. Full article

Amid global environmental changes, urbanisation erodes nature connectedness, an important driver of pro-environmental behaviours and human well-being, exacerbating human-made risks like biodiversity loss and climate change. This study introduces a novel hybrid agent-based model (ABM), calibrated with historical urbanisation data, to explore how urbanisation, opportunity and orientation to engage with nature, and intergenerational transmission have shaped nature connectedness over time. The model simulates historical trends (1800–2020) against target data, with projections extending to 2125. The ABM revealed a significant nature connectedness decline with excellent fit to the target data, derived from nature word use in cultural products. Although a lifetime ‘extinction of experience’ mechanism refined the fit, intergenerational transmission emerged as the dominant driver—supporting a socio-ecological tipping point in human–nature disconnection. Even with transformative interventions like dramatic urban greening and enhanced nature engagement, projections suggest a persistent disconnection from nature through to 2050, highlighting locked-in risks to environmental stewardship. After 2050, the most transformative interventions trigger a self-sustaining recovery, highlighting the need for sustained, systemic policies that embed nature connectedness into urban planning and education. Full article

Periodontal disease is a common and serious oral disease among older adults. As the global older population increases, preventing periodontal disease is vital for healthy ageing. Poor oral hygiene, uncontrolled diabetes, and smoking are key risk factors of periodontal disease. Improving oral hygiene, diabetes management, and quitting smoking are essential health behavioural change interventions to manage periodontal disease. The objective of this study is to review the prevention of periodontal disease among older adults through health behavioural change interventions. Effective strategies to improve oral hygiene include personalised education on proper brushing and interdental cleaning. Educating caregivers is equally important as they supervise care-dependent older adults to maintain oral health. For those with diabetes, physical activity improves glycated haemoglobin levels and clinical periodontal parameters by reducing reactive oxygen species and systemic inflammation. Smoking cessation could be achieved through a multi-faceted approach. Effective smoking cessation combines brief interventions with intensive behavioural/pharmacological support for long-term success, especially in highly dependent individuals. Tailored strategies for older adults, integrated care, and expanded research improve outcomes and health equity in ageing populations. In conclusion, health behavioural change interventions are non-invasive preventive measures that include oral hygiene reinforcement, diabetic management, and smoking cessation. Prioritising these interventions empowers older adults to maintain oral health, reducing disease burden and enhancing overall well-being for healthy ageing. Full article

Addressing climate change requires not only knowledge but also psychological resilience. This study examined whether integrating Mental Mode Management (MMM) self-regulation training with climate education improves pro-environmental outcomes and emotional responses to climate change. In a randomised 2 × 2 design, 44 participants were assigned to either a control group (CG; n = 21), which received a six-week climate education programme, or an experimental group (MMM; n = 23), which received the same education plus MMM training. Pro-environmental attitudes, behaviours, carbon emissions, climate change anxiety, mindfulness, and executive functions were assessed at baseline and post-intervention. A follow-up was also conducted six months later. Both groups showed increased pro-environmental attitudes post-intervention (η² = 0.3) and reduced food-related emissions (η² = 0.107). No changes were observed in pro-environmental behaviour scores or global carbon footprint. While neither intervention affected overall climate anxiety or cognitive impairment, functional impairment increased in the CG and decreased in the MMM group (η² = 0.177), with mindfulness facet acting with awareness moderating this effect. These findings contribute to sustainability research by showing that integrating climate education with psychological training enhances environmental awareness and fosters emotionally resilient engagement with climate challenges, supporting individual-level contributions to broader sustainability goals. Full article

This study investigates the cybersecurity landscape of Aotearoa-New Zealand through a culturally grounded lens, focusing on the integration of Indigenous Māori values into cybersecurity frameworks. In response to escalating cyber threats, the research adopts a mixed-methods and interdisciplinary approach—combining surveys, focus groups, and case studies—to explore how cultural principles such as whanaungatanga (collective responsibility) and manaakitanga (care and respect) influence digital safety practices. The findings demonstrate that culturally informed strategies enhance trust, resilience, and community engagement, particularly in rural and underserved Māori communities. Quantitative analysis revealed that 63% of urban participants correctly identified phishing attempts compared to 38% of rural participants, highlighting a significant urban–rural awareness gap. Additionally, over 72% of Māori respondents indicated that cybersecurity messaging was more effective when delivered through familiar cultural channels, such as marae networks or iwi-led training programmes. Focus groups reinforced this, with participants noting stronger retention and behavioural change when cyber risks were communicated using Māori metaphors, language, or values-based analogies. The study also confirms that culturally grounded interventions—such as incorporating Māori motifs (e.g., koru, poutama) into secure interface design and using iwi structures to disseminate best practices—can align with international standards like NIST CSF and ISO 27001. This compatibility enhances stakeholder buy-in and demonstrates universal applicability in multicultural contexts. Key challenges identified include a cybersecurity talent shortage in remote areas, difficulties integrating Indigenous perspectives into mainstream policy, and persistent barriers from the digital divide. The research advocates for cross-sector collaboration among government, private industry, and Indigenous communities to co-develop inclusive, resilient cybersecurity ecosystems. Based on the UTAUT and New Zealand’s cybersecurity vision “Secure Together—Tō Tātou Korowai Manaaki 2023–2028,” this study provides a model for small nations and multicultural societies to create robust, inclusive cybersecurity frameworks. Full article

Background: Antenatal depression and anxiety contribute significantly to maternal morbidity and adverse pregnancy outcomes. However, structured screening and targeted interventions are largely absent from standard prenatal care in many Eastern European countries, including Bulgaria. This study examines the prevalence and psychosocial predictors of antenatal psychosocial risk using the validated Antenatal Risk Questionnaire–Revised (ANRQ-R) in a nationally underrepresented population. Methods: A cross-sectional survey was conducted among 216 third-trimester pregnant women in Bulgaria. Data on sociodemographic characteristics, health behaviours, and reproductive history were collected. Multivariate logistic regression identified predictors of elevated psychosocial risk. Results: A total of 65.7% of participants met the criteria for elevated psychosocial risk. Significant risk factors included passive smoking exposure during pregnancy (OR = 5.03, p < 0.001), physical activity prior to pregnancy (OR = 1.81, p = 0.004), and a family history of hereditary disease (OR = 42.67, p < 0.001). Protective factors were better self-rated current health (OR = 0.37, p = 0.004), the presence of chronic illness (OR = 0.42, p = 0.049), previous childbirth experience (OR = 0.11, p = 0.032), and residence in Northwestern Bulgaria (OR = 0.31, p = 0.028). Despite the high prevalence of psychosocial vulnerability, only 9.5% of affected women sought professional help. Conclusions: While our findings point to important unmet needs in antenatal mental health, further research is required before national screening policies can be implemented. Pilot programs, cultural validation of tools, and system-level readiness assessments should precede broad adoption. Full article

Cardiovascular disease (CVD) remains the foremost global cause of mortality, driven significantly by modifiable lifestyle factors. This study employs a data-driven approach to identify and evaluate these risk factors using advanced machine learning techniques. Analysing a large publicly available dataset of over 300,000 adult health records containing lifestyle behaviours, clinical risk factors, and self-reported health indicators, this research implemented traditional classifiers, ensemble methods, and deep learning architectures to examine the impact of behaviours such as smoking, diet, physical activity, and alcohol consumption on CVD risk. The Random Forest model demonstrated superior performance, achieving high accuracy, recall, and ROC-AUC scores. To demonstrate real-world utility, the model was deployed as an interactive Streamlit web application. This tool allows individuals to input lifestyle and health data to receive real-time CVD risk predictions, offering a novel, user-friendly prototype that bridges machine learning insights with personalised digital health engagement. This tool can facilitate personalised health monitoring and supports early detection by providing actionable insights. The findings underscore the efficacy of predictive modelling in informing targeted interventions and public health strategies. By bridging advanced analytics with practical applications, this research offers a scalable framework for reducing CVD burden, paving the way for precision medicine and improved population health outcomes through data-driven decision-making. Full article

Riverbed dynamics are natural processes that are strongly driven by human and climatic factors. In the last two centuries, the anthropogenic influence and impact of climate change on European rivers has resulted in significant degradation of riverbeds. This research paper aims to determine the historical evolution (1856–2021) and future trends of the Ialomița riverbed (Romania) under the influence of anthropogenic impact and climate change. The case study is a reach of 66 km between the confluences with the Ialomicioara and Pâscov rivers. The localisation in a contact zone between the Curvature Subcarpathians and the Târgoviște Plain, the active recent tectonic uplift of the area, and the intense anthropogenic intervention gives to this river reach favourable conditions for pronounced riverbed dynamics over time. To achieve the aim of the study, we developed a complex methodology which involves the use of Geographical Information System (GIS) techniques, hierarchical cluster analysis (HCA), the Mann–Kendall test (MK), and R programming. The results indicate that the evolution of the Ialomița River aligns with the general trends observed across Europe and within Romania, characterised by a reduction in riverbed geomorphological complexity and a general transition from a braided, multi-thread into a sinuous, single-thread fluvial style. The main processes consist of channel narrowing and incision alternating with intense meandering. However, specific temporal and spatial evolution patterns were identified, mainly influenced by the increasingly anthropogenic local influences and confirmed climate changes in the study area since the second half of the 20th century. Future evolutionary trends suggest that, in the absence of river restoration interventions, the Ialomița riverbed is expected to continue degrading on a short-term horizon, following both climatic and anthropogenic signals. The findings of this study may contribute to a better understanding of recent river behaviours and serve as a valuable tool for the management of the Ialomița River. Full article